支付方式对医疗保险费用控制的实证研究——以江苏镇江市为例  

Empirical research on the effect of payment system on medical insurance expense control sampled with Zhenjiang City

作　　者：刘石柱[1] 詹长春[1] 周绿林[1] 

机构地区：[1]江苏大学管理学院,江苏镇江212013

出　　处：《中国卫生事业管理》2012年第12期909-912,共4页Chinese Health Service Management

基　　金：教育部人文社科研究项目(编号:09YJG840013)

摘　　要：文章分析了镇江市医疗体制改革以来在医疗保险支付方式上的调整及其原因,比较了不同时期支付方式带来的费用控制、参保人群健康状况及就医情况的变化情况。对目前采用的支付方式进行了研究,针对存在的管理指标与手段还比较粗放、仍有不合理的医疗保险费用支出等问题,在预算管理政策、费用结算及质量管理指标体系、多方谈判机制等方面提出了完善建议。The regulation of medical insurance payment system since the implementation of medical reform in Zhenjiang city were analyzed to comparatively study the changes in expense control, participants＇ health and medical treatment situation in differ- ent payment system. Some problems were obtained, mainly as inaccurate management index and unreasonable medical insurance payment. Based on which, some suggestions were put forward, such as budget management policy, expense account, quality control index system and negotiation system.

关 键 词：支付方式 医疗保险 费用控制 

分 类 号：F842.6[经济管理—保险]